There are two ways AIDS is transmitted: by blood-to-blood contact and by intimate sexual contact. Period. That is the case for children as well as adults.
There is not a single reported case of AIDS resulting from casual contact. Coughing, hugging, crying, toilet seats, shared utensils, saliva -- none of these has been established to transmit AIDS.
If there were any basis to the common fears one hears these days, then ambulance drivers, doctors, nurses, firemen and the police would all be reporting cases of AIDS from caring for or assisting persons with AIDS. Not one such case has been reported. So, too, parents and siblings in the same house with persons with AIDS would be coming down with the disease. Again, no cases reported.
As further proof, six separate studies by the Centers for Disease Control of family members of persons with AIDS have failed to demonstrate any risk of infection to adults who had no sexual contact with the infected patients.
In light of all the evidence, why are we manufacturing concerns of disease transmission based on theoretical possibilities?
It is important to recognize that school-age children are not a high-risk group. In fact, most of the pediatric cases of AIDS (about 180 out of 13,000 cases, with only about 90 still alive) are the result of intrauterine transmission from the mother during birth. Many of these children are too young or too sick to attend school. The remainder are likely to be preschool age.
How many school-age children with AIDS are there? No more than 20 percent of the total number of pediatric cases have gotten AIDS from blood transfusions or blood products, and only some of those are of school age. But, again, we are talking about a very small number -- probably no more than 30 cases nationwide.
And, in the schoolroom, we are not waiting, as some have suggested, for a catastrophe to break loose. Indeed, the number of school-age children with AIDS is certain not to increase at the same level, and may actually decline, as a result of the HTLV-III antibody test that protects the blood supply against donations from persons who have been exposed to the virus.
However, in the case of very young children, there is good reason to be cautious, because parents need to have a sense of confidence about the safety of the school environment. Caution is also justified in order to minimize exposure that might result from scratching, vomiting, diarrhea, biting and spitting.
The Centers for Disease Control, which has published guidelines for local schools on these issues, provides an exception for those cases, particularly for preschool-age children, where there is even a remote risk of transmission.
There is also the issue of teachers and other school employees who have AIDS. Undoubtedly there will in the future be more teachers with AIDS than students with AIDS. And there are those who, regardless of the medical condition of the individual, would refuse to permit employees with AIDS to continue to work in the schools.
There is no more medical justification for tossing teachers out of their jobs than there is for firing lawyers with AIDS, or accountants, or university professors. Moreover, society's interests are best served by allowing persons with AIDS, who pose no threat to their co-workers or those they serve, and who are capable of working, to remain productive in their jobs.
The AIDS controversy underscores the need for a major effort aimed at educating the public about the real risks, as well as the unfounded fears, associated with the disease. In our experience at the Whitman-Walker Clinic, once people receive sound medical information, their concerns are very much diminished.
At the risk of being labeled "sentimentalists," there is something else that we think is very important. And that is the way we as people responded to serious illness that affects our fellows. What we need is not a hysterical reaction that serves no purpose other than to multiply the grief of those who have the disease. What we need instead is what President Reagan, in his recent remarks on the United Way campaign, referred to as our nation's "greatest treasures" -- and that is, "the good and decent and noble virtues of the American heart." Let's not lose sight of that in this debate.